Transition probabilities and duration analysis among disability states: Some evidence from Spanish data

In this paper we study the disability transition probabilities (as well as the mortalityprobabilities) due to concurrent factors to age such as income, gender and education. Althoughit is well known that ageing and socioeconomic status influence the probability ofcausing functional disorders, surprisingly little attention has been paid to the combined effectof those factors along the individuals' life and how this affects the transition from one degreeof disability to another. The assumption that tomorrow's disability state is only a functionof the today's state is very strong, since disability is a complex variable that depends onseveral other elements than time. This paper contributes into the field in two ways: (1) byattending the distinction between the initial disability level and the process that leads tohis course (2) by addressing whether and how education, age and income differentially affectthe disability transitions. Using a Markov chain discrete model and a survival analysis, weestimate the probability by year and individual characteristics that changes the state of disabilityand the duration that it takes its progression in each case. We find that people withan initial state of disability have a higher propensity to change and take less time to transitfrom different stages. Men do that more frequently than women. Education and incomehave negative effects on transition. Moreover, we consider the disability benefits associatedto those changes along different stages of disability and therefore we offer some clues onthe potential savings of preventive actions that may delay or avoid those transitions. Onpure cost considerations, preventive programs for improvement show higher benefits thanthose for preventing deterioration, and in general terms, those focussing individuals below65 should go first. Finally the trend of disability in Spain seems not to change among yearsand regional differences are not found.

Relative and absolute reliability of the clinical version of the Narrow Path Walking Test (NPWT) under single and dual task conditions.

Decline in gait stability has been associated with increased fall risk in older adults. Reliable and clinically feasible methods of gait instability assessment are needed. This study evaluated the relative and absolute reliability and concurrent validity of the testing procedure of the clinical version of the Narrow Path Walking Test (NPWT) under single task (ST) and dual task (DT) conditions. Thirty independent community-dwelling older adults (65-87 years) were tested twice. Participants were instructed to walk within the 6-m narrow path without stepping out. Trial time, number of steps, trial velocity, number of step errors, and number of cognitive task errors were determined. Intraclass correlation coefficients (ICCs) were calculated as indices of agreement, and a graphic approach called "mountain plot" was applied to help interpret the direction and magnitude of disagreements between testing procedures. Smallest detectable change and smallest real difference (SRD) were computed to determine clinically relevant improvement at group and individual levels, respectively. Concurrent validity was assessed using Performance Oriented Mobility Assessment Tool (POMA) and the Short Physical Performance Battery (SPPB). Test-retest agreement (ICC1,2) varied from 0.77 to 0.92 in ST and from 0.78 to 0.92 in DT conditions, with no apparent systematic differences between testing procedures demonstrated by the mountain plot graphs. Smallest detectable change and smallest real change were small for motor task performance and larger for cognitive errors. Significant correlations were observed for trial velocity and trial time with POMA and SPPB. The present results indicate that the NPWT testing procedure is highly reliable and reproducible.

Improving Transition Outcomes: Lessons Learned from the Prototypes

Final Improving Transition Outcomes grant paper detailing the Lessons Learned during the life of the grant.

Improving Transition Outcomes: Promising Transition Practices

Summary of the Promising Transition Practices implemented under the Improving Transition Outcomes with Iowa Vocational Rehabilitation Services grant.

Improving Transition Outcomes: Lessons Learned from the Improving Transition Outcomes Prototypes

Final Improving Transition Outcomes grant paper detailing the Lessons Learned during the life of the grant.

Improving Transition Outcomes: Council Bluffs Youth Connections: E-Mentoring Replication Template

Replication Template for Improving Transition Outcomes Council Bluffs Youth Connections E-Mentoring Prototype. This concise document will help your community team implement and plan for sustaining e-mentoring.

Improving Transition Outcomes: Henry County Transition Partners: Infrastructure Building Replication Template

Replication Template for Improving Transition Outcomes Henry County Transition Partners Prototype. This concise document will help you build a community team and the infrastructure necessary to implement and plan for sustaining specific initiatives.

Improving Transition Outcomes: CASE (Career And Self Exploration): Replication Template

Replication Template for Improving Transition Outcomes CASE (Career And Self Exploration) Prototype. This concise document explains how your team can implement CASE and the corresponding entrepreneurship component.

Improving Transition Outcomes: Henry County Transition Partners: Guidebook Part 1

Part 1 of 7 for Henry County's Transition Partners Guidebook specific to youth with disabilities transitioning from high school to employment, post-secondary education, or adult services.

Improving Transition Outcomes: Resource Mapping Workshop: Additional Information

Information used/presented during the Improving Transition Outcomes Resource Mapping Workshops

Improving Transition Outcomes: Resource Mapping Workshop: Service Matrix

Resource Mapping tool from the Improving Transition Outcomes Resource Mapping Workshops

Improving Transition Outcomes: Resource Mapping Workshop: Resource List

Resource Mapping resources shared during the Improving Transition Outcomes Resource Mapping Workshops

Improving Transition Outcomes: Henry County Transition Partners: Guidebook Part 2

Part 2 of 7 for Henry County's Transition Partners Guidebook specific to youth with disabilities transitioning from high school to employment, post-secondary education, or adult services.

Improving Transition Outcomes: Henry County Transition Partners: Guidebook Part 3

Part 3 of 7 for Henry County's Transition Partners Guidebook specific to youth with disabilities transitioning from high school to employment, post-secondary education, or adult services.

Improving Transition Outcomes: Henry County Transition Partners: Guidebook Part 4

Part 4 of 7 for Henry County's Transition Partners Guidebook specific to youth with disabilities transitioning from high school to employment, post-secondary education, or adult services.